Active NPI
Adam Scott Edelstein, MS, CCC-SLP
- Speech-Language Pathologist
- Davie, FL
National Provider Identifier
1972677813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 6004
- Practice address
- 12545 Orange Dr
Davie, FL 33330-4306 - Phone
- (954) 236-9415
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 6004 | FL | Primary |
Addresses
Primary practice location
12545 Orange Dr
Davie, FL 33330-4306
Mailing address
881 NW 130TH Ave
Pembroke Pines, FL 33028-3135
Phone (954) 438-1467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8886466 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 6004 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972677813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "881 NW 130TH AVE",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330283135",
"telephone_number": "954-438-1467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12545 ORANGE DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333304306",
"telephone_number": "954-236-9415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELSTEIN",
"first_name": "ADAM",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 6004",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8886466",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.